Back to Work with Bipolar Disorder: Part I

By Candida Fink MD
March 31, 2009

Many people with bipolar disorder are able to successfully return to work once they’re on an effective treatment regimen, which typically includes one or more medications. In Bipolar Disorder for Dummies, however, we recommend that you avoid mood stressors and triggers – and returning to work, especially a demanding job, can be loaded with stressors and triggers. In this two-part series on returning to work with bipolar disorder, we offer some suggestions on how to ease the transition back to work.

Every individual and situation is different. Some people have no option but to return to work full-time and really have very little support from loved ones. Others may have a tremendous support network, an understanding supervisor, and very accommodating co-workers. Some people may even find that returning to work is less stressful than staying home, and they really embrace the opportunity to return to work.

Following are some suggestions that can ease the transition back to work:

Meet with your doctor first. You may need a doctor’s release to return to work. In addition, your doctor may offer some helpful suggestions concerning how to handle your medications in the workplace.
Set up a doctor’s appointment ahead of time for the end of your first work week. By setting up an appointment in advance, you can return to work knowing that if anything goes wrong, you can get in to see your doctor soon. You can always cancel if things are going well.
Consider any workplace accommodations that can help you function more effectively at work. Under the ADA (Americans with Disabilities Act), you have a right to reasonable accommodations. Check out the Job Accommodation Network’s “Accommodation and Compliance Series: Employees with Bipolar Disorder” by Kendra M. Duckworth. This publication can help you identify accommodations that people with bipolar disorder find particularly helpful.
Discuss your return with your supervisor. You’re not required by law to disclose your diagnosis or treatment, but if you feel comfortable disclosing this information, it may make your supervisor a little more understanding and flexible.Tip: You can often predict how your supervisor may react to your diagnosis by thinking back to actions she performed or words she uttered in the past. How accommodating has your supervisor been regarding other illnesses and absences from work? Has she ever made unkind remarks about people who were “nutjobs” or “headcases?” Past behaviors are the best predictors of future behaviors.
Discuss your return with one or more coworkers you trust. Again, you have no obligation whatsoever to disclose your diagnosis or treatment. In fact, a disclosure may not always be the best idea. But if you have coworkers you trust, a support person on the job can help you watch for early warning signs and avoid potential conflicts.
Lighten the load at home. If you have a partner or other loved one who can relieve some of your burden at home, ask him or her to take on some additional responsibilities or chores or hire help (if you can afford it). If someone else can chip in by paying the bills, picking up the house, cooking, and making sure the kids (if any) are taken care of, at least temporarily, you may feel less stress at work.

Note: You may need to submit medical forms and other paperwork to receive sick pay or other benefits, but keeping up on all the paperwork can be quite stressful and difficult when you’re feeling depressed or overwhelmed. Get help from a family member or friend, a union representative, or your employer’s human resource department. Union representatives and HR workers are typically very knowledgeable about your rights and dedicated to making sure that your employer follows the proper legal procedures.

From Joe: When my wife was experiencing her worst mood episodes early on, when we really had no understanding of bipolar disorder, her doctor would simply prescribe medications and send her back to work. Looking back, it reminds me of a boxer who’s getting pummeled in the ring being patched up in his corner and then sent back into the ring to get pounded some more.

She wasn’t well enough to return to work. The major breakdown made her weak and confused. When she did return to work, her mind was in such a fog that she couldn’t perform her job duties, which understandably increased the stress she was feeling and ultimately led to another breakdown and all the fallout that resulted from it. Now, not only did she feel stress, but she also felt like a failure.

I think a lot of times people have no choice but to get patched up with a few meds and try to return to work before they’re fully healthy. But if you have enough sick time and a support network in place, I would strongly advise that you avoid returning to work prematurely. If possible, wait until you feel fully healthy and ready.

Please post a comment to share your insights and experiences with others, and please check back next week for Part II of “Back to Work with Bipolar Disorder.”

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Links to This Article

From Psych Central's Dr. Candida Fink & Joe Kraynak:
Back to Work with Bipolar Disorder: Part II | Bipolar Beat (April 7, 2009)

4 Comments to
“Back to Work with Bipolar Disorder: Part I”

Franz Kafka at 7:49 am on April 1st, 2009

Advising someone to confide in a co-worker is not good advice. A co-worker is someone you have probably not known as long as a friend for example. Thus that person’s loyalty is not to you even though you may feel they are trustworthy.

Joe Kraynak at 8:01 am on April 1st, 2009

Franz, you must have overlooked the qualifying phrase - “In fact, a disclosure may not always be the best idea.” The truth is that it really depends on the person and the situation. I’ve known co-workers who have been very good about holding discussions in confidence and long-time “friends” who have broken such confidence.

Confiding to a co-worker may have positive or negative results.

zapf at 12:04 am on April 2nd, 2009

A long-time diagnosed BP1 here . You have to be really careful about co-workers, bosses, board members and yourself in this position. MANY people in this competitive environment collect negatives to try to get rid of you, and believe me the world does not look kindly on bi-polars and mental illnesses. I made the mistake of working for a very nasty crazy lady who took my week´s absence for treatment and totally screwed me, turning into another huge depressive crisis. And despite laws, people CAN AND DO get rid of you for mental illness, so in some cases its tough to get legit sick leave.

Pamela C at 6:41 pm on July 29th, 2009

Ever since I started working at age 18, I have gone from job to job. I was undiagnosed with bipolar disorder until I was 48 years old. I was a hard worker, especially when manic, but because of the nature of bipolar disorder, I had trouble keeping jobs, especially not getting along with bosses or co-workers. I went to several pdocs over the years, I knew something was wrong, but it was always the depression side that was treated…I loved my highs and didn’t think anything was wrong, so never shared that with doctors. I am also an alcoholic, so life has been pretty much hell. Finally I got really sick. I got in the state system and a very smart pdoc finally diagnosed me. I was so sick I was unable to work anymore. He encouraged me to apply for disability, which I did and was put on disability.

It was 5 years before I felt like trying to work again. I was used to high-stress jobs, which probably explained why I would lose jobs, so I tried to find work as simple as possible, such as housekeeping in a local hospital, or working at home on my computer parttime. I still changed jobs, it’s the nature of the beast for me. Finally I got a job as a home health aide. I had to list the medications I was on, which included psychotropic meds, so I told them I was bipolar. They accepted me! But I have to be very careful not to take on too much work. I only work two 7 hr days a week, then one 5 hour day a week. I just can’t work anymore than that. I need the extra money or I would quit work altogether.

I think it’s wonderful that many bipolar folks return to work, I am on medications that, after many years of trying many meds, work for me to an extent. I have many side effects so can’t take a therapeutic dose, or also they cause physical ailments.

Anyway, I am 62 now, ready to rest, it’s been a hard life, and working just made it worse. I wish anyone returning to work all the luck in the world. Just remember, try an avoid high stress work, or ones that cause triggers, take your meds! and keep in mind that disability is there for a reason if you are unable to work.